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Bill Walczak and the leaders of Steward Health Care could not agree: The new president of Carney Hospital wanted to create an obstetrics unit to attract more young families from Dorchester. The for-profit parent company rejected the idea.

The dispute led to Walczak’s ­departure from Carney last April, just 14 months after he took the job. At the time, he said little about what had happened, but as he embarks on a campaign for mayor of Boston, advisers and analysts say he will have to explain his brief tenure with Steward and why he left.

“This issue is going to come up, and he’s going to have to defend himself,” said Stephen J. Weymouth, a Boston lawyer and a board member at Codman Square Health Center, a nonprofit that Walczak led for about 35 years before leaving for Carney.

In an interview this week, ­Walczak talked more openly about his departure, explaining that the primary point of tension with leadership was over the obstetrical unit.

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While the Globe previously ­reported that associates had said Walczak was fired, he said this week that he left the hospital post by ­“mutual agreement.” Such contracts often involve an exchange of confidentiality for severance pay.

Walczak said he is no longer receiving payments from Steward, but added that the agreement he signed prevents him from disclosing its terms.

Walczak’s abbreviated term as hospital president could be seen as an example of how he stood firm behind what he ­believed his neighborhood needed in the troubled Carney. But opponents could point to his inability to lead a resurgence at the Carney as evidence that he lacks the executive leadership skills necessary to manage a complex city government despite decades spent as a head of the health center.

“I knew it was a very high-risk job for me,” said Walczak, now vice president of external relations for Shawmut Design and Construction. “I wanted to help turn around this hospital.”

Health care leaders were watching closely to see what Steward, backed by New York investment firm Cerberus Capital Management, would do with its newly purchased chain of Catholic hospitals, when the company began recruiting ­Walczak.

Weymouth and others advised him against leaving the health center for the uncertainty of working for Steward. Some were angered by his move to for-profit care. But Walczak said he remembered how impor­tant Carney was, at its height, to residents of Dorchester.

Walczak had married a Dorchester native and moved to Codman Square in the mid-1970s, when the neighborhood flared with racial tension, white families were moving out, and fires scarred abandoned houses.

He and others in the community began planning a health center, to be located in a shuttered library. When the doors opened in 1979, after a protracted fight with the admin­istration of Mayor Kevin White to secure the building, Carney issued Walczak’s paychecks. The hospital had ­offered its payroll and other back-office services to get the center started.

Today, the center serves about 21,000 patients and has become a platform for other projects. Under Walczak’s leadership, it worked with partners to create financial literacy education, a fitness center, and programs to address youth violence in the neighborhood.

“If you’re going to have the infrastructure of a health center — and what I mean by that is space, as well as management — you can build other things off of it,” Walczak said.

Walczak said he wanted to create a strong family medicine department at the Carney to attract young families.

Walczak led the center’s ­efforts to create a first-of-its-kind charter school within the health center, with the goal of providing adult mentors and exposing students to possible careers in health care.

The school opened in 2001, and last year the health center and Codman Academy moved into a new 34,000-square-foot building, built by Shawmut and named for Walczak.

Over the years, the role of Codman Square Health Center and nearby health centers grew as the Carney began to struggle financially under leadership of the Catholic Archdiocese of Boston and Caritas Christi Health Care. In the late 1980s, the hospital stopped collaborating with the community health centers it had helped to create.

By the time Steward bought the hospital and five others in 2010, rumors of the Carney’s closing were common. “The community breathed a sigh of relief” when Steward leaders hired Walczak, taking it as a sign that they were serious about revitalizing the facility, said Joe Burnieika, a longtime board member at Dorchester House Multi-Service Center, who led external communications at Carney during ­Walczak’s tenure there.

Walczak worked to rebuild behavioral health services, includ­ing an adolescent psychiatry unit whose staff he replaced after an employee’s ­alleged sexual assault of a ­patient and a subsequent investigation revealed serious safety problems.

He built a strong rapport with the medical staff of the hospital because of his commitment “to keep it going against all odds,” said Dr. John O. ­Pastore, a Steward cardiologist and former vice president for medical affairs.

“It’s very difficult for a hospital president to be widely ­respected and loved by his medical staff, but I think Bill was,” said Pastore, who is supporting Walczak’s bid for mayor.

Walczak said he wanted to create a strong family medicine department at the Carney. To anchor it and attract young families from the neighborhood, he said the hospital needed an obstetrical unit. “You’ve got to be able to deliver babies,” he said. “You’ve got to be able to treat the whole family. My plan was dependent on that.”

Steward’s leaders had a different plan. The hospital would not attract enough deliveries to support a high-quality obstetrical unit, said spokesman Chris Murphy. “The community has already voted with its feet” by going elsewhere for that care, he said. “We’ve researched it, and we feel that an OB service at Carney would not meet that threshold.”

The hospital system won state approval in February to create a 13-bed obstetrical unit at Quincy Medical Center, about 4 miles away.

Murphy, who declined to discuss specifics of Walczak’s departure, said his successor, Andy Davis, is working to reestablish relationships with community health centers in Dorchester, with some success.

“We are invested in Carney’s success,” he said.

Some watching the mayor’s race said Walczak’s stint at the Carney might be more problematic if there were a well-known corporate executive in the race, with a more formidable record in the private sector.

Without such an opponent, former Boston city councilor Lawrence S. DiCara said, ­Walczak’s challenge could be in explaining how his work at Codman Square prepared him for the mayor’s office.

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